Prevalence and location of tobacco smoke exposure outside the home in adults and children in the United States

•This study provides insight into the prevalence and location of self-reported TSE outside the home in US adults and children.•Sixty-nine percent of adults reported TSE outside their home in the past week, most often on a sidewalk or outside a building.•Thirty-three percent of parents reported outside the home TSE for their children in the past seven days.•Many US adults and children are exposed to tobacco smoke outside the home in indoor, outdoor, public, and private settings.

ObjectivesTobacco smoke exposure (TSE) is associated with many adverse health outcomes. The goal of this study was to provide insight into the prevalence and location of self-reported TSE outside the home for US adults and children.Study designCross-sectional survey.MethodsData from a nationally representative sample of US adults from 2014 were included. Participants who responded that they smelled smoke during the past seven days in various settings were considered to have been exposed to TSE. Parents were asked about TSE exposure of their children.ResultsSixty-nine percent of all adults reported TSE outside their home in the past seven days. The most common exposure location among adults was on a public sidewalk and outside the doorway of a building (both 33%). Thirty-three percent of parents reported outside the home TSE for their children in the past seven days. Most commonly, the reported exposure was 'In some other place(s)' (16%), followed by at a relative's house (10%).ConclusionsThis study reports on TSE outside the home in a wide variety of settings and a broad range of ages in a nationally representative US sample. A high proportion of US adults and children are exposed to TSE outside the home in indoor, outdoor, public, and private settings. Smoke-free laws, clinical interventions, education, and a change in social norms are required to stop TSE.